Medical Emergency

What happens when a medical emergency develops on your flight?

The flight attendants immediately spring into action. They have a checklist to follow and attend to the afflicted passenger, getting a general idea of the symptoms, prior conditions, and any medication being taken. After they do this, the flight attendants will ask if there are any medical personnel on board and then immediately notify the Captain of the potential medical problem and what is being done about it.

Once the Captain is notified, s/he starts organizing and planning the proper response. Most airlines have a medical emergency checklist that the crew can use to help in being methodical in addressing the needs of the afflicted passenger. Of course, if there are medical personnel on board, this greatly helps the crew in their response. With the input from the flight attendants, information from the afflicted passenger (if able), and/or accompanying passenger(s), and/or medical personnel; the Captain will decide on the next course of action. Most of the time, if there is any doubt, and to be on the safe side, the Captain will call the respective airline's operations center to not only alert the flight dispatcher of the potential medical emergency, but also to start getting in contact with ground medical personnel. The Captain must always carefully weigh the needs of the afflicted passenger versus the safety of the rest of the passengers. Just like any emergency, the Captain will usually divide the duties of her/himself and the First Officer and/or other pilots that are part of the crew. The Captain will do all the coordinating between the flight attendants, flight dispatch, and medical personnel on the ground. The First Officer will fly the aircraft and talk to ATC (Air Traffic Control).

Many airlines have phones on board that the crew can use to call for assistance in a medical emergency. This is one of the best tools that the crew can use to get information and help. Unfortunately, many aircraft still do not have this capability. This is due to a number of reasons. There could have been a previous service offered, but then went out of business (GTE Airfone for example). The airline you are on, in a cost-cutting effort, might have done away with this phone service; or the airline might have phone service on some of its' aircraft fleet and not others. Many airlines are now getting satellite phones (SATCOM -Satellite Communications) to enhance their communications ability. Also, with new generation aircraft, the pilots have the ability to type and send messages to dispatch over a data link. This is better than nothing, but it still slows the communication process down, and in a medical emergency many times the medical facility you are talking to you does not have this capability. Therefore, you have to relay through flight dispatch to get the information to them. Finally, for older aircraft that do not have the data link capability, and as a backup for those aircraft that do, is a voice communications procedure called a phone patch. More on this in a later section, but this is where you must call an ARINC (Aeronautical Radio, Inc.) radio frequency to request a phone patch to a particular phone number. ARINC will then connect to your requested phone number. However, many times, this is not particularly clear and you can hear your voice being repeated, making for a slow means of communications. Also, many times through this method, you cannot have a 3-way conversation which you can have on phone service. This 3-way capability is a great enhancement for faster and more accurate information. If your aircraft does have this capability then many times even the flight attendants can connect and talk directly to the doctor, or if there were medical personnel on board then they too can talk via this means. It used to be (before the 9/11 incidents), that we could have brought medical personnel into the cockpit to be able to talk to not only the pilots, but also to a medical doctor over the radio. With the secure cockpits we have today this is no longer an option.

Almost all airlines have medical assistance standing by on a 24/7 basis. This is provided either in-house or contracted out. For example, one of the major contracting companies is called Medaire. Their service, called Medlink, is located inside the Good Samaritan Regional Medical Center in Phoenix, Arizona, United States. They have emergency physicians on hand to help the final decision maker- the Captain of your flight, make the final decision whether to continue on to your destination or divert to the closest available airports and hospitals for the medical emergency. This is a tremendous aid to the crew. So while there are a couple of medical kits and AED (Automatic External Defibrillator) on board (more on this in another section), that the flight attendants are trained to use, there is other medical supplies that only licensed medical personnel (doctors, nurses, paramedics) can use to help with some evaluation and treatment of the afflicted passenger. This is what the physicians on the ground are specifically trained and responsible for: medical assessment of the afflicted passenger and provide on board treatment instructions, evaluating the condition and recommending to the Captain on diverting or continuing to destination, providing information on availability of medical facilities on route of flight, and coordinating all the medical assistance required upon landing, either at destination or a divert location.

Just like any other emergency, this is where the crews' experience and ability to work together can really stand out to make it safe for all. Using all the inputs available (flight attendants, flight dispatch, medical personnel onboard, medical assistance from the ground), can greatly enhance your Captain's ability to make a sound decision on how to handle the medical emergency on board your flight.